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Meta-Analysis
. 2023 Dec;47(12):3308-3318.
doi: 10.1007/s00268-023-07191-2. Epub 2023 Oct 10.

The Presence of an Aberrant Right Hepatic Artery Did Not Influence Surgical and Oncological Outcomes After Pancreaticoduodenectomy: A Comprehensive Systematic Review and Meta-Analysis

Claudio Ricci  1   2 , Laura Alberici  3 , Margherita Minghetti  3 , Carlo Ingaldi  3 , Davide Giovanni Grego  3 , Vincenzo D'Ambra  3 , Ermenegilda De Dona  3 , Riccardo Casadei  3   4
Affiliations
Meta-Analysis

The Presence of an Aberrant Right Hepatic Artery Did Not Influence Surgical and Oncological Outcomes After Pancreaticoduodenectomy: A Comprehensive Systematic Review and Meta-Analysis

Claudio Ricci et al. World J Surg. 2023 Dec.

Abstract

Background: The presence of an aberrant right hepatic artery (a-RHA) could influence the oncological and postoperative results after pancreaticoduodenectomy (PD).

Methods: A systematic review and metanalysis were conducted, including all comparative studies having patients who underwent PD without (na-RHA) or with a-RHA. The results were reported as risk ratios (RRs), mean differences (MDs), or hazard ratios (HRs) with 95% confidence intervals (95 CI). The random effects model was used to calculate the effect sizes. The endpoints were distinguished as critical and important. Critical endpoints were: R1 resection, overall survival (OS), morbidity, mortality, and biliary fistula (BL). Important endpoints were: postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), post pancreatectomy hemorrhage (PPH), length of stay (LOS), and operative time (OT).

Results: Considering the R1 rate no significant differences were observed between the two groups (RR 1.06; 0.89 to 1.27). The two groups have a similar OS (HR 0.95; 0.85 to 1.06). Postoperative morbidity and mortality were similar between the two groups, with a RR of 0.97 (0.88 to 1.06) and 0.81 (0.54 to 1.20), respectively. The biliary fistula rate was similar between the two groups (RR of 1.09; 0.72 to 1.66). No differences were observed for non-critical endpoints.

Conclusion: The presence of a-RHA does not affect negatively the short-term and long-term clinical outcomes of PD.

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Conflict of interest statement

Claudio Ricci, Laura Alberici, Margherita Minghetti, Carlo Ingaldi, Davide Giovanni Grego, Vincenzo D’Ambra, Ermenegilda De Dona, and Riccardo Casadei declared no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA Flowchart
Fig. 2
Fig. 2
Forests plot of R1 resection rate in malignant tumors. naRHA Patients without aberrant right hepatic artery; aRHA Aberrant right hepatic artery; RR Risk ratio
Fig. 3
Fig. 3
Forests plot of morbidity. naRHA Patients without aberrant right hepatic artery; aRHA Aberrant right hepatic artery; RR Risk ratio
Fig. 4
Fig. 4
Forests plot of biliary fistula. naRHA Patients without aberrant right hepatic artery; aRHA Aberrant right hepatic artery
See this image and copyright information in PMC

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